HOUSTON - Combat in Iraq and Afghanistan has demonstrated the nature of modern warfare has changed. There are new causes of injury, improvements in body armor, and surgical stabilization at the front-line of combat. More war-wounded are returning with complex, multiple injuries such as amputations, traumatic brain injuries, spinal cord injury, visual impairments, and psychological adjustment problems. Moreover, improvised explosive devices, blasts (high pressure waves), landmines, rocket-propelled grenades, and explosive fragments now account for the majority of combat injuries.
Blast-related injuries are often “polytraumatic,” meaning they result in injury and/or impairment to more than one body system or organ, and often require specialized intensive rehabilitation processes and coordination of care across the full continuum.
Of these injured military personnel, about 60 percent have some degree of traumatic brain injury. The frequency and unique nature of these blast injuries create the need for a unique interdisciplinary polytrauma rehabilitation program to handle the ongoing rehabilitative, psychological, medical, and prosthetic needs of these individuals.
In 2005, the Michael E. DeBakey VA Medical Center (MEDVAMC) added an extremely important program to its array of available health care services, a Network Polytrauma Program.
As part of the VA’s Polytrauma System of Care, the program at the MEDVAMC provides both inpatient and outpatient services using an interdisciplinary team consisting of specialty physicians, rehabilitation therapists, neuropsychologists, speech pathologists, audiologists, prosthetists, blind rehabilitation specialists, social workers, psychologists, psychiatrists, and other disciplines, with access to the full range of medical and support services within the medical center.
Findings from initial patient assessments trigger appropriate treatments and/or referrals to other specialists in the areas of brain injury evaluation and treatment, amputation management and prosthetics, visual and hearing impairment, and treatment for post traumatic stress disorder.
The goals of the MEDVAMC Polytrauma Program are to provide post-acute medical assessment to patients injured by blasts or accidents; provide medical, rehabilitation, and psychological treatment services; coordinate care as patients move from acute hospitalization through rehabilitation and ultimately back to the home and community; provide case management and family support through all phases of treatment; monitor short and long-term outcomes for these individuals; and continue a program of research to better under-stand the effectiveness of treatments for traumatic brain injuries, spinal cord disabilities, and mental health problems.
The VA Polytrauma System coordinates the transfer and provision of health care for polytrauma patients within the VA and between VA and the Department of Defense to ensure timely access to Veteran health care benefits. In addition to rehabilitation services and psychosocial support for both patient and family, the VA offers education and training to prepare patients and families for success after going home.
“The Polytrauma Program reflects VA’s commitment to care for the men and women who have served in uniform. A reality of combat is that some return with loss of limbs, traumatic brain injuries, and other severe injuries,” said Stephanie Sneed, M.D., Polytrauma/Traumatic Brain Injury Program director. “The DeBakey VA recognizes it must provide specialized care for military service members and Veterans who sustained multiple and severe injuries.”